Losing the ability to communicate can be one of the most frustrating and difficult problems for people with dementia, their families and carers.

As the illness progresses, the person with dementia may gradually lose their ability to communicate. They find it more and more difficult to express themselves clearly and to understand what others say.

Dementia and communication

Each person with dementia is unique and the difficulties experienced in communicating thoughts and feelings are different for each individual.

The changes you might notice in the person with dementia include:

They may have difficulty in finding a word and may use familiar words repeatedly. A related word might be given instead of one they cannot remember.

They may invent new words to describe familiar objects.

They may have difficulty organising words logically.

They may easily lose their train of thought.

They may be able to understand only part of what you are saying to them.

The person's reading and writing skills may deteriorate over time.

They may respond inappropriately in conversation such as interrupting at the wrong time, using swear words or ignoring the person speaking to them.

They may have difficulty in expressing their needs and emotions.

If English is the person's second language the person may revert to their native tongue.

It is also important to check if the communication problems being experienced are not due to impaired vision or hearing. Glasses or a hearing aid may help some people. Check that hearing aids are functioning correctly and glasses are cleaned regularly.

Tips for communicating with a person with dementia

Communicate in a positive manner, use warm facial expressions and appropriate eye contact. Communicate feelings of worth and affection.

Introduce yourself every time you meet them. The person with dementia may have forgotten who you are. Using name tags with large print may help the person recall names of family and friends.

Ensure a quiet environment free from loud back ground noises such as the radio or TV.

Always approach the person from the front and use their name when talking to them.

Give the person your full attention when having a conversation.

Let the person know you are listening and trying to understand what is being said.

Give the person time to think so as to describe whatever he or she wants. Be careful not to interrupt. Allow extra time for the person to respond. This process can be difficult for some people who are used to always talking.

Avoid criticizing, correcting and arguing, this could lead to conflict.

If the person uses the wrong word or cannot find a word, try guessing the right one.

Focus on the feelings, not the facts. Look for the feelings behind the words.

Use gentle touch where appropriate to emphasise a point you are trying to make.

Use short, simple sentences. Speak slowly and remember you are speaking to an adult.

If the person doesn't respond, wait a moment. Then ask again. Try not to ask questions that rely on a good memory.

It is best to give simple explanations on a subject, as complicated explanations may not be clearly understood.

Sometimes it is more worthwhile to just sit and say nothing, to enjoy the silence and the moment together.

When communicting with a person with dementia do not:

Argue with the person

Order the person around

Tell the person what they can't do - focus on what they can do

Be condescending, or use a condescending tone of voice

Ask a lot of direct questions that rely on memory

Talk about the person as if they are not there

For more information on dementia and communication refer to the Alzheimer's Australia Help Sheet on Caring for someone with dementia and Communication